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South Dakota rates for HCPCS 21295

Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.77 / $202.77 / $2,290.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.16 / $202.77 / $470.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.11 / $463.56 / $579.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.87 / $320.26 / $492.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.10 / $391.21 / $8,054.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.24 / $502.62 / $1,544.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.13 / $406.76 / $509.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.61 / $319.14 / $391.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.92 / $339.05 / $527.41
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.30 / $475.00 / $475.00